Transfusion Reactions

Type of Reaction	Symptoms and Signs
Febrile	Pyrexia, rigors.
Circulatory Overload	Increase in blood pressure, heart rate and respirations. Pulmonary oedema, dyspnoea, increase in urinary output
Allergic	Urticaria, facial oedema, dyspnoea, hypotension
Haemolytic	Collapse with hypotension. Shock, pyrexia, rigors, haemoglobinuria, haemoglobinaemia, oliguria, later uraemia.
Infected Blood	Pyrexia, profound collapse and shock, pallor, dyspnoea, low blood pressure, rapid pulse.

Management of Transfusion Reactions

Follow the steps below to manage the baby’s reaction to blood and blood products.

Step	Action
1	STOP THE TRANSFUSION IMMEDIATELY.
2	The Nurse contacts the Doctor/NS-ANP immediately the baby manifests any sign of reaction.
3	Babies vital signs must be recorded and documented.
4	Maintain patency of cannula using a new giving set and 0.9% sodium chloride.
5	Check label and recipient ID information is correct.
6	Send NZBS Notification and Investigation of Adverse Transfusion form and the blood product with IV giving set attached in a plastic bag to the Blood Bank immediately to allow investigation of the cause of the reaction.
7	Notify Blood Bank by phone; discuss urgency of follow-up tests and further transfusion needs.
8	Take a sample of baby’s blood (from a different vein). Blood group serology and EDTA – in purple top tube - send to Blood Bank. FBC + serum biochemistry.
9	Consider need for blood cultures is sepsis suspected. Blood gases if respiratory distress present. Urine check for haemoglobinuria. Coagulation screen if bleeding.
10	Parents of baby are informed.